Dismantling the pipeline

The Children's Defense Fund (CDF) recently published America's Cradle to Prison Pipeline, a report on "an urgent national crisis at the intersection of poverty and race": the high lifetime risk of Black and Latino boys going to jail.

Poor children of color are the canaries in America's deep mines of child neglect and racial and economic injustice. At critical points in their development, from birth through adulthood, millions of these children confront a multitude of disadvantages and risks including poverty and its many stresses....These accumulated and convergent risks form a Cradle to Prison Pipeline, trapping these children in a trajectory that leads to marginalized lives, imprisonment and often premature death.

The report's proposed steps to help these children include:

• A fundamental paradigm shift from the first choice of punishment and incarceration to early intervention and sustained child investment
• Health and mental health coverage for every child and coverage of pregnant women
• Quality Early Head Start, Head Start, child care and preschool so that every child is school-ready
• Creating an ethic of achievement and high expectations for every child

The report was released at a summit held at Howard University last month.

According to its website, CDF is a private, nonprofit organization that provides a voice for the children of America, particularly poor and minority children and those with disabilities, and encourages preventive investment for these children. CDF was founded by Marian Wright Edelman in 1973.


America's Cradle to Prison Pipeline (pdf, 244pp/6.6MB)

Less than half for our children

The New England Journal of Medicine current issue includes a study on the quality of care for children in the United States.

On average, according to data in the medical records, children in the study received 46.5%...of the indicated care. They received 67.6%...of the indicated care for acute medical problems, 53.4%...of the indicated care for chronic medical conditions, and 40.7%...of the indicated preventive care.

According to this study, previous results were limited to select groups (e.g., Medicaid recipients), involved self-reporting by caregivers and guardians, or were collected from data on the overall adult population.

In an attempt to address the limitations of previously published studies of the quality of care provided to children, we developed a comprehensive method for evaluating quality on the basis of information in medical records.

Deficits in the quality of healthcare for children "are similar in magnitude to those previously reported for adults." The results were surprising because the participants were more likely to be white and to have private insurance.

The researchers have found no national commitment to improve children health care.

Expansion of access to care through insurance coverage, which is the focus of national health care policy related to children, will not, by itself, eliminate the deficits in the quality of care.

The Quality of Ambulatory Care Delivered to Children in the United States
(The New England Journal of Medicine, October 11, 2007, pdf, 9pp/136KB)

Abstract available (HTML)